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Sexual Wellness

Is ED Permanent? A Urologist’s Top Picks to Reverse Erectile Dysfunction

Fact Checked

Will erectile dysfunction go away on its own or is this something you’ll have to deal with forever? A urologist shares the most effective ways to heal ED.

Last Updated: 02/04/2025

Written by

Kimberly Wilkes

When you’re in bed with your partner, you can’t get or maintain an erection no matter what they do to turn you on. It’s frustrating for you both. You wonder if there’s anything you can do or if you’re stuck with your erectile dysfunction forever.

Many men with this same problem are wondering, “Is erectile dysfunction permanent?” To answer this question, we turned to Paul Thompson, M.D., a urologist and surgeon with more than 30 years’ experience. In this blog post, Dr. Thompson tackles the subject of whether you can reverse ED and reveals the most effective treatments to make it go away for good.

Causes of Erectile Dysfunction

“If you suffer from ED, there’s no need to feel hopeless. In most cases, erectile dysfunction can be treated without surgery, but we need to dig down to the root cause of the problem in order to choose the right treatment,” says Dr. Thompson.

He lists the following causes as the ones he most often identifies in clinical practice:

Lifestyle

Smoking, drinking too much alcohol, lack of exercise, and gaining weight can all contribute to causing ED. According to research, only about 29% of men see improvements in their sexual function with lifestyle changes alone.(1)

Even so, these changes can improve underlying medical conditions, as well as have other benefits such as support the health of the blood vessels. Dr. Thompson also notes that changing your lifestyle can make other erectile dysfunction treatments even more effective.

Low Testosterone

Testosterone deficiency is another common cause of erectile dysfunction that Dr. Thompson frequently observes in clinical practice. Low testosterone levels affect poor erectile function, and the lower the testosterone levels, the worse the severity of erectile dysfunction.(2)

Aging

Aging is one of the top risk factors for ED. Erectile dysfunction becomes more common in men who are 50 or older, but Dr. Thompson sees it happen in younger men, too. According to the Massachusetts Male Aging Study, 52% of men have ED, and the incidence of ED increases from 5% at age 40 to 15% of men who are 70 years old.(3)

In another study, the researchers found that 76.5% of men ages 50 to 75 had ED symptoms.(4) The prevalence of ED increased as the men got older. Erectile dysfunction occurred in 67% of men 50 years old while 89% of 75-year-old men had ED.

Nerve Damage

This can happen after prostate cancer surgery. During this type of surgery to remove the prostate gland, the surgeon will try to spare the nerves from damage, which reduces the risk of erectile dysfunction. However, even during this nerve-sparing surgery some damage can occur, making ED a common risk factor.

Underlying Medical Conditions

Conditions like diabetes, chronic kidney disease, high blood pressure, and cardiovascular disease can all impact sexual function. For example, an estimated 35% to 75% of diabetics have erectile dysfunction, and ED develops 10 to 15 years earlier in men who have diabetes compared to men without diabetes.(5) Men with diabetes also tend to have vascular disease, which contributes to ED.

Oral Medications

According to Dr. Thompson, certain medications are known for causing ED, and he sees this frequently in his patients. The drugs that are the worst offenders include:

Antidepressants
Antihistamines
High blood pressure medicines such as atenolol
Thiazide diuretics
Parkinson’s medications
Opioid painkillers

Other medications linked to erectile dysfunction include:

H2 blockers (Zantac, Tagamet, Pepcid)
Lipid-lowering drugs
Non-steroidal anti-inflammatory drugs (ibuprofen, etc.)

“The good news,” says Dr. Thompson, ”Is that once we identify a medication as the cause of your erectile dysfunction, we can change the medication to one less likely to cause problems.”

Mental Health Factors

Dr. Thompson sees men in clinical practice whose erectile dysfunction has psychological roots. He refers them to counseling or sex therapy as a way to reverse the condition and improve their erectile function.

Can ED Be Reversed?

“Once we’ve narrowed down the cause of the erectile dysfunction, we can then work on restoring erectile function,” says Dr. Thompson. “Addressing the root cause of the erectile problems rather than just treating the symptoms is an effective approach that has a high success rate.”

Here are the treatments Dr. Thompson recommends to patients, sometimes as a stand-alone therapy or sometimes used together to reverse erectile dysfunction.

Lifestyle

Dr. Thompson finds that combining lifestyle changes together with another ED treatment is an especially effective way to reverse erectile dysfunction. Losing weight, cutting back on alcohol intake, exercising, and eating right can all improve blood flow and reduce the risk of underlying physical health conditions linked to erectile dysfunction.

Dr. Thompson notes that the Mediterranean diet is particularly effective in men with erectile dysfunction.

He points out, “There’s some good research, including a review of the medical literature, to show that the Mediterranean diet is involved in preventing erectile dysfunction by stabilizing high blood sugar, increasing antioxidants, and boosting levels of the amino acid arginine, which can increase blood flow and is involved in erectile function.”(6)

Address Underlying Medical Conditions

Work with your doctor to treat health conditions that could play a role in your erectile dysfunctions. Your doctor can help you lower blood pressure and high cholesterol, treat heart disease, and deal with other problems that might interfere with vascular health.

ED Medications

ED medications aren’t always Dr. Thompson’s ED treatment of choice, because they have side effects and in some men, they eventually stop working within one to two years or less.(7) In a study published in the Journal of Urology, researchers found that the effects of ED drugs wore off in one to 18 months in 16 of 43 men.

They’re also only a band-aid solution that doesn’t get at the root cause of the problem. However, he says, ED medications can be used while waiting for other more permanent solutions to take effect.

Acoustic Soundwave Therapy

As far as ways to improve erectile function, Dr. Thompson speaks highly of acoustic soundwave therapy, also known as low-intensity extracorporeal shockwave therapy (Li-ESWT). He’s used it in his clinic for over a decade with a great deal of success.

The one challenge? In-clinic Li-ESWT is expensive and out of reach of many average guys. That’s why Dr. Thompson recommends an at-home version of acoustic soundwave therapy that’s equally effective but at a fraction of the cost of in-clinic therapy.

Many of Dr. Thompson’s patients who have used the at-home version report enjoying morning wood again for the first time in years.

“At-home acoustic soundwave therapy is really at the forefront of men’s sexual health,” says Dr. Thompson. “It’s really rewarding to see so many of my patients transform their sex life with this innovative device.”

Vacuum Erection Device

Otherwise known as a penis pump, a vacuum erection device is something many of Dr. Thompson’s patients use to encourage healthy erections. He usually recommends using it together with acoustic soundwave therapy for the best results.

To use a pump, place it over the penis and pump the air out to create a vacuum. This causes blood to flood the shaft of the penis, leading to an erection. To help you stay erect during sex, slide a constriction band down to the lower end of the penis and then remove the pump before having sexual intercourse.

Penis Ring

A penis ring, also known as a cock ring, is used around the base of the penis to constrict blood vessels, which improves blood flow and helps maintain an erection. Dr. Thompson likes to recommend a smart penis ring, which does more than just improve sexual performance.

“This new type of device has some impressive features, such as it instantly boosts firmness, tracks your progress, and enhances pleasure,” says Dr. Thompson. “It even gives tailored sexual health advice.”

Counseling

If a patient is showing signs of psychological factors such as depression or performance anxiety, Dr. Thompson will refer him to a therapist. In these cases, Dr. Thompson says, ED can usually be reversed by treating the underlying emotional issues.

Frequently Asked Questions About Is ED Permanent?

Is ED temporary?

Dr. Paul Thompson, a urologist and surgeon in practice for more than three decades, has an admirable success rate in helping men get rid of their erectile dysfunction.

As long as a man takes action to do something about his decline in erectile function, then there’s a good chance of success, notes Dr. Thompson. The sooner a man begins to work with his doctor to find an effective solution, the greater the chance that ED can be reversed.

Using more than one strategy also is the best way to achieve success, Dr. Thompson says, for example, using an acoustic soundwave therapy device at home while also putting into practice lifestyle changes such as getting more exercise and eating healthier.

Can ED from diabetes be reversed?

Erectile dysfunction is really common in men with diabetes. An estimated 35% to 75% of men with diabetes have erectile dysfunction.

The good news? Dr. Thompson has seen a lot of his diabetic patients improve their erectile function through intensive lifestyle changes.

His experience matches that in the medical literature, where research has found that men with diabetes who adopt a healthier lifestyle reduce their diabetes symptoms and erectile dysfunction. The most effective strategies include getting enough moderate physical activity, eating a healthy diet low in saturated fat, and losing weight.

Can ED go away with lifestyle changes?

Changing your lifestyle can go a long way in improving sexual function, but only 29% of men experience improvements solely with changes in their lifestyle and using no other approaches.

Dr. Thompson sees the fastest results when changes to lifestyle are combined with other techniques such as using a smart ring, a penis pump, or an acoustic soundwave device.